Low-birth-weight rate reduced by the obstetrical access project.

Area of Science:

• Public Health
• Maternal and Child Health
• Health Services Research

Background:

• Medicaid pilot project in 13 California counties (July 1979-June 1982).
• Aimed to improve healthcare access in underserved areas and enhance pregnancy outcomes.
• Provided comprehensive prenatal care, including psychosocial, health education, and nutrition services.

Purpose of the Study:

• Evaluate the effectiveness of the Obstetrical (OB) access program.
• Assess improvements in prenatal care initiation and completion rates.
• Determine the impact on low birth weight rates and the program's benefit-cost ratio.

Main Methods:

• Registered 6,774 women in the project.
• Compared low-birth-weight rates with a matched control group.
• Calculated the short-run benefit-cost ratio, considering savings in neonatal intensive care.

Main Results:

• 87% of registrants began prenatal care in the first or second trimester.
• 84% of registrants completed the program.
• OB access mothers had a 4.7% low-birth-weight rate versus 7.0% in the control group (33% reduction).
• Program yielded a short-run benefit-cost ratio of approximately 2 to 1.

Conclusions:

• The OB access program successfully improved access to and completion of prenatal care.
• Demonstrated a significant reduction in low birth weight and positive economic benefits.
• Led to statewide legislative approval for Medi-Cal recipients in 1984.